| NPI | 1225419138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT123439) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional (Licence: CA APCC3700) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 106H00000X Marriage & Family Therapist (Licence: CA IMF98516) | |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2020-12-07 |